I am creating this log (also created as a blog entry) in hopes that it helps others. I was blessed with nearly-perfect skin my entire life, until the age of 23. I began having occassional breakouts, mostly on my chin around my mouth, and visited my first dermatologist. These minor breakouts seemed like a big deal to me at the time, since I had never experienced this before. I was prescribed Duac. Within 1 month, my face was crystal clear once again. Using duac as needed kept me clear for almost 3 years. Starting around the time I turned 26, the breakouts returned. In addition to chin/mouth area breakouts, I began experiencing blemishes on my cheeks for the first time ever. It was devastating, especially being a professional 26 year old who never experienced this level of breakouts. I saw another derm who prescribed Duac, since it worked for me in the past. It did not work this time around. For the past year and a half, I have been dealing with this breakout. I have had almost-clear periods (where I will only have 1 active blemish), but for the most part I have not been clear. This is very abnormal for me, and was causing much concern. I just was not healing, or if I thought that a blemish healed, it would reappear a couple weeks later in the same spot.

14 weeks ago I went to a new derm. He prescribed Solodyn (minocycline- 55 mg/1xday), and 2 topicals: Finacea at night, and Klaron during the day. I used these products religiously for 6 weeks, and was still not clearing. At the 6 week mark I had a follow up, and the derm added Ziana to my regimen to "spot treat". He also gave me a couple injections (I think cortisone?) on active blemishes. [side bar: Does anyone else seem to experience this after injections? The blemish he targeted went down, but a day or two later, one right next to it appears out of nowhere and is painful. Could this be a reaction to injection?]. I felt as though the Klaron may have been causing breakouts, so I used more sparingly. I am also on Ortho-tri-cyclen Lo, and have been for 1.5 years. I feel like this cause some melasma and also may be contributing to the acne, since it got worse around the same time.

I have become increasingly concerned about this regimen, because my breakouts and red marks after breakouts have gotten significantly worse. I used to have clear skin after a blemish. I now have dark red marks and discoloration, even though I do not "pick".

After adding in the Ziana, I still wasn't clear. Let me specify that at any given time I probably have 4 active blemishes, mostly on my chin. There were a few stubborn marks on my cheeks, but nothing that can't be covered easily with makeup.

At my 13 week mark, I went for a follow-up (couldn't get in at 12 weeks). I described my frustration, and my doctor prescribed Spironolactone (generic of Aldactone). He said the area where I usually breakout makes him believe this is hormonal. He said he would keep my on Solodyn for now (in case of inital breakout), but wean me off slowly if the Spiro works. I questioned my derm about going off birth control, but he suggested staying on for now.

I created this log to track my progress, and hopefully create a dialogue about what works/ doesn't.

After a couple days on Spiro, I thought I felt a difference. I began on a Tuesday, and by Friday I had a painful blemish under the skin. Monday I could feel 1 more developing under the skin. It is now exactly 1 week on Spiro. I have 3 active, large and painful blemishes on my chin. 1 blemish underneath the skin (has been there for a month or so, am wondering when it will surface), and a couple of tiny spots that I am not worried about. This may seem like small potatoes to others, but to me it has been an emotionally and physically painful journey. To make matters worse, I went to the derm 14 weeks ago because I wanted "perfect" skin for my wedding. I now feel that things are worse than they were 3 months ago, and now have only 6 months left until the wedding.

Fingers crossed that Spiro is magic. I will update in a few days. In the meantime, feel free to share any stories/advice!

Hey lady. I understand your frustration - I didn't start breaking out until I was 19 and it has only ever been around my chin area. I have had all my hormones tested and they are low/normal. But I am on week 12 of Spiro myself. So far I haven't seen much of a reduction in oil but I am also on minocycline and that has helped with the acne. I'm afraid to go off the mino in case the Spiro makes me break out. Just so you know, Spiro takes a long time to work. Many people here report 3 months, although my endo says 6-9. So be patient! And maybe up your dose of mino. Have you had your hormones tested?

Thanks! No, I haven't had my hormones tested yet. What topicals are you using?

What dose of mino are you taking? My doctor put me on 55 because of my weight (110 lbs), but I definitely feel like the mino should be helping more than it is! Maybe I will try increasing.

I am supposed to go back to my derm in 3 weeks to see how the Spiro is going. He suggested Smoothbeam as a sort of "quick fix" for the chin, if Spiro is not working. Maybe I should wait on that a little longer...

Today is day 10 and I thought I would give a brief update. The 3 blemishes I described on Tuesday are healing. This is much faster than normal. Perhaps it is the Spiro working already, or in combination with the Solodyn? Not sure. I have noticed my skin is drier than normal, which is not necessarily a bad thing. From what I have read, Spiro reduces oil in the skin, so this would make sense. Certain areas of my face are a little peely, but I also use topicals. I still have a couple of teensy bumps, but I can deal with that for now.

I am hoping that this trend continues, and that there is not an initial breakout. Only time will tell, but I am optimistic today.

I am on 50mg of Minocycline a day. I think it really helps to bring down any breakouts quickly. I am still holding out hope that Spiro will work on its own but I am still too scared to stop the mino. If it were me, I would wait on the Smoothbeam. There are risks to laser and it's not a guaranteed fix - it seems that your acne isn't too bad at the moment anyway! I am only using differin here and there to help with any inflammation I see coming in. Other than that just a gentle cleanser and moisturizer with sunscreen. After years of harsh topicals I am trying to give my skin a rest from that.

I really like the finacea. I love the texture, and I think it works well on both blemishes and lightening marks. I am also using it for melasma on my forehead (thanks to birth control and sun sensitivity, I now have that to deal with in addition to blemishes! And I am only 27. Oh joy!). It is hard to tell what is the catalyst when you are using so many topicals, but I do think finacea helps the marks. It kind of stings the first couple weeks, but now my skin is used to it.

I haven't been using AHA before, but I just bought the Dr. Dennis Gross Alpha Beta peels (glycolic and salicylic acid) at Sephora last night, hoping to get a jump start on the melasma and the dark marks.

Thanks Michi! I think I will stay away from lasers...I'm too scared! And after 2 weeks of Spiro in addition to Solodyn and topicals, my skin is doing much better! I haven't had any large new blemishes, but I still have a few clogged pores on my chin and on my right cheek. They arent that noticeable, but would like those to go away. I have 1 blemish from last week that is still healing on my chin. I am hoping the Solodyn and topicals helped avoid any initial breakout from the spiro. How is it going for you?

I should also add that I use the following daily supplements: 2 950 mg Omega 3 EPA and DHA; 3 1000 IU Bitamin D3 (blood tests show I am very deficient, so my allergist put me on these); 2 advanced acidophilus 1.5 billion microorganisms.

I also follow a gluten, sugar and (mostly) dairy free diet. I originally eliminated these foods due to possible allergies, but after skin and blood tests, my allergist says I am not allergic. However, I just feel better when I avoid these things.

I'm on 100mg of Spiro which is usually the recommended minimum to see results, although some people have good results with less. I am approaching week 14. Right now my skin is basically clear but I don't know whether to attribute that to the Spiro or the minocylcine. When I blot my chin is still oily so that makes me think it's the mino, because Spiro should be stopping this!

I am on 50 mg of Spiro and 55 mg of Solodyn. Today is day 17 on Spiro. The 1 blemish leftover from week 1 on my chin is still healing, and I have had a few new clogged pores pop up (I can see some on my cheek, and a couple on my chin). They aren't really noticeable and I don't think they will develop into anything, but I wonder if / when these will stop coming. I have not had any new breakouts since week 1. I am optimistic, but since it is still early I am still a little anxious about whether I will get the results I am hoping for. I am hoping my no breakout streak continues, so that I can focus on addressing uneven skin tone and pigmentation from old blemishes.

I had been on Solodyn for 14 weeks before starting Spiro, and only began seeing results when I started Spiro. This makes me think the Spiro is working, but it has only been a little over 2 weeks. Most people say it takes a few months.

Michi - Wow 14 weeks! What kind of acne did you have before? Did you notice any decreasing of oil and do you feel like you got clear after a certain amount of time?

Cwctmo - I am mostly dealing with clogged pores. Like tons if them on my cheeks and jaw. They were there doing nothing for months and in the past month or two they have started to get inflamed and turn into either white heads or deep pustules. Regardless of what they are or whether I touch them or not they always leave a red mark...so although I don't have many active pimples I have a gazillion clogged pores and red marks. I'm wondering if this is all due to the retin a because I never got red marks that lasted more than 2-3 days before. Do you feel like the spiro is helping with your clogs and oil? How do your clogged pores typically resolve themselves?

Hmmm...it is hard to describe it. I think they are clogged pores, just tiny bumps that sometimes turn into a whitehead. Usually once I exfoliate at the end if the day, they go away. These didnt start popping up until i started the Ziana, before that my problem was larger blemish breakouts.

I have definitely noticed a decrease in oil. I wear Klaron, sunscreen, and liquid foundation and my face is not oily at the end of a 10 hour work day. It used to be oily after a few hours of just makeup! Like I said before, I'm not sure whether it is the Spiro working already or if it is the topicals + Solodyn finally kicking in, but my skin has cleared dramatically in the past 2 weeks. Which coincides with starting Spiro. The spiro has also coincided with my having shorter lifespans with both blemishes and clogged pores.

I agree with you that certain topicals might make us more susceptible to red marks. Prior to seeing the dermatologist 16+ weeks ago, I didn't have any red marks (even if I picked). Now it seems that even when I don't touch my face at all, I have a leftover mark from blemishes. I think the Finacea is helping with the red marks because they seem to be getting lighter.

I am looking forward to my 3 week mark on Spiro. I will keep you updated!

So, I had my 4 month follow up with my derm today. I have been taking Minocycline, Finacea, and Klaron for 4 months; Spiro for 3.5 weeks. On Monday I had a new cyst-like blemish form on my cheek, which was frustrating. I also had 1 blemish on my chin left over from 3 weeks ago. My derm attacked the 2 blemishes today, so hoping they will heal quickly. I opted not to go for Smoothbeam today, because I only have a few blemishes. I don't want to do something so extreme if it is not necessary. It is a little frustrating that it has been 4 months, but I am glad to be seeing some progress. Last week I was experiencing some clogged pores. I bought some Neutrogena face wash (the orange salycilic acid kind) at the pharmacy, and it cleared the clogged pores right up! I was kind of amazed because for the last year I have spent ungodly amounts of money at Sephora on expensive products, and this $8.00 wash worked like a charm. It is a bit drying, but I think my skin needs to get accustomed to it. I have also been using benzoyl peroxide to spot treat. I have decided that Ziana is not for me. When I use it I wake up with oily skin and clogged pores. Everyone is different, so this might work for others, just not for me.

I am still thinking of getting of the birth control pill, since I feel like it increased my acne and caused melasma. I am just worried about breaking out. Hopefully Spiro will get me completely clear, and then I can tackle the melasma and discoloration.

Any updates from anyone else?

I forgot to add, my derm upped my dosage of spiro to 100 mg from 50 mg. Hoping I don't have a reaction to the increase. Anyone have experience increasing this amount?

So I upped my dosage of Spiro to 100 mg on Friday. So far it is going ok. My skin has been pretty dry, but I am also using a salicylic acid wash, so that might be contributing. I am a bit frustrated because this morning my 2 remaining blemishes seemed to be clearing, but after lunch I looked in the mirror and can see/ feel a new one forming on my chin. Make that 2. Large bumps beneath the skin with no head. I don't understand why this keeps happening. Tomorrow will be my 1 month mark on Spiro (only on 50 mg up until Friday). Hopefully the 100 mg does the trick! I am getting married in 5 months, and I want to stop worrying about my skin! I feel like I am waiting to be excited about the wedding until my skin is 100% clear. It is so frustrating, especially since a short time ago I didn't have these problems!

My derm suggested weaning off the Solodyn, so I didn't take it on Saturday, took it Sunday, and haven't taken it today yet. Maybe I should take it 2 days on, 1 day off, instead of going straight to every other day? I don't want to have a reaction to going off of the Solodyn, especially since I just increased my Spiro dosage. I am getting frustrated because my derm seems to have a "whatever you want to do" attitude about everything (topicals, pills, peels, lasers, etc.), and I feel that as the doctor he should be giving me more advice!

Any suggestions?

I find myself wishing for 2 years ago when I never even thought about my skin! Now all I can do is think about it (or even 5 months ago when it was not that bad).

I think you will see more results with 100 mg. I recently bumped up to 100 as well. That seems to be the standard dosage for clearing. I am also using SA liquid every other night with Retin a micro and am on Doxy for a month...kinda anxious to get off it, antibiotics hurt my stomach. 5 months sounds like plenty of time for you to clear and plenty of time for Spiro to really work. Hang in there I bet you will be clear for your wedding!

So I upped my dosage of Spiro to 100 mg on Friday. So far it is going ok. My skin has been pretty dry, but I am also using a salicylic acid wash, so that might be contributing. I am a bit frustrated because this morning my 2 remaining blemishes seemed to be clearing, but after lunch I looked in the mirror and can see/ feel a new one forming on my chin. Make that 2. Large bumps beneath the skin with no head. I don't understand why this keeps happening. Tomorrow will be my 1 month mark on Spiro (only on 50 mg up until Friday). Hopefully the 100 mg does the trick! I am getting married in 5 months, and I want to stop worrying about my skin! I feel like I am waiting to be excited about the wedding until my skin is 100% clear. It is so frustrating, especially since a short time ago I didn't have these problems!

My derm suggested weaning off the Solodyn, so I didn't take it on Saturday, took it Sunday, and haven't taken it today yet. Maybe I should take it 2 days on, 1 day off, instead of going straight to every other day? I don't want to have a reaction to going off of the Solodyn, especially since I just increased my Spiro dosage. I am getting frustrated because my derm seems to have a "whatever you want to do" attitude about everything (topicals, pills, peels, lasers, etc.), and I feel that as the doctor he should be giving me more advice!

Any suggestions?

I find myself wishing for 2 years ago when I never even thought about my skin! Now all I can do is think about it (or even 5 months ago when it was not that bad).

Thanks so much for the encouragement lifeinfaith!! It helps a lot. Tomorrow will be 6 weeks on Spiro, and I am pleased with my progress. Especially since bumping up to 100 mg, I am seeing some positive changes. My skin is finally getting clear! The nasty bump from last week cleared up over the weekend, and I haven't seen or felt any new ones forming on the chin! My skin is pretty dry right now, but nothing a little moisturizer can't control. I had 2 clogged pores spring up on my upper cheeks (near the nose) last night, but I am glad I haven't felt any cysts forming. I'm hoping I finally turned the corner! I will update later in the week when it is 2 weeks since the bump to 100 mg.

I am anxious to get to 6-8 weeks when improvements are supposed to be more noticeable. I'm coming up on 4 weeks and have a checkup with my derm this week. I was told after a month on Doxy to take it down from 200 to 100 mg and then after I am consistently not having swollen ones anymore to wean off completely. Im hoping to do that in the next month as my clogged pores come out the swollen pimples get further and farther between. Counting on the spiro and retin a to work together for preventing new ones. I really need something for my leftover red marks. Have you used anything for that ?

I have been using the dr. Dennis gross alpha beta peel every other day, salicylic acid wash with my clarisonic every day, and finacea every night. The red marks seem to be rapidly fading! I have a few left, but am hoping now that the breakouts have mostly stopped I can focus on these.

As for the spiro, 2 weeks on 100 mg has made a huge difference! I haven't had a new blemish since
last week, and the remaining couple have healed. Hoping this continues!